NSG 4100 – Exam 3 (2026) | Comprehensive
100-Question Practice Exam with Detailed
Answers and Rationales| pdf
Detailed Overview:
This study guide is a complete, exam-style practice resource for NSG 4100 Exam 3 (2026). It
contains 100 multiple-choice questions designed to cover the full spectrum of essential nursing
knowledge and clinical reasoning skills needed to succeed on the exam.
The questions encompass a variety of critical nursing areas, including:
1. Medical-Surgical Nursing: Assessment, management, and interventions for acute and
chronic conditions such as heart failure, COPD, pneumonia, pancreatitis, stroke, and
sepsis. Students will practice prioritizing care, identifying complications, and applying
evidence-based interventions.
2. Pharmacology: Knowledge of commonly prescribed medications, including mechanism
of action, side effects, interactions, and patient teaching. Focus areas include
anticoagulants, diuretics, insulin, corticosteroids, bronchodilators, and antibiotics.
3. Pathophysiology and Lab Interpretation: Understanding disease processes and
recognizing laboratory and clinical indicators of complications, such as DKA, hepatic
encephalopathy, electrolyte imbalances, and shock states.
4. Patient Safety and Nursing Interventions: Prioritization of nursing care, prevention of
hospital-acquired infections, pressure ulcers, and medication errors, along with proper
monitoring and rapid response to emergencies.
5. Critical Thinking and Clinical Judgment: Each question challenges the student to
analyze patient data, make safe clinical decisions, and implement appropriate
nursing interventions.
1. A patient with chronic heart failure is prescribed furosemide. Which
assessment finding indicates the medication is effective?
A. Increased heart rate
B. Decreased urinary output
C. Reduction in peripheral edema
D. Elevated blood pressure
Rationale: Furosemide is a loop diuretic that promotes fluid excretion. A reduction in edema
indicates effective fluid removal and symptom relief.
,2. A nurse is caring for a patient with COPD. Which oxygen delivery method
provides the most precise concentration?
A. Nasal cannula
B. Simple face mask
C. Venturi mask
D. Non-rebreather mask
Rationale: Venturi masks deliver a precise oxygen concentration, which is crucial for patients at
risk of CO2 retention, such as those with COPD.
3. A patient receiving vancomycin reports itching and develops a rash. What is
the nurse’s priority action?
A. Administer antihistamines and continue infusion
B. Stop the infusion and notify the provider
C. Slow the infusion rate
D. Monitor vital signs every 15 minutes
Rationale: Rash and itching may indicate “red man syndrome” or an allergic reaction. The
infusion should be stopped immediately and the provider notified.
4. A patient presents with a blood glucose level of 280 mg/dL and reports
polyuria, polydipsia, and blurred vision. Which condition is most likely?
A. Hypoglycemia
B. Type 1 diabetes mellitus
C. Hyperglycemia / uncontrolled diabetes
D. Syndrome of inappropriate antidiuretic hormone (SIADH)
Rationale: Symptoms of high blood sugar, including polyuria, polydipsia, and blurred vision,
indicate hyperglycemia, commonly seen in uncontrolled diabetes.
5. Which action should the nurse take first for a patient experiencing an
anaphylactic reaction?
, A. Administer corticosteroids
B. Administer epinephrine
C. Apply oxygen
D. Place the patient supine
Rationale: Epinephrine is the first-line treatment for anaphylaxis, as it reverses airway
constriction and hypotension. Oxygen and positioning follow.
6. A patient with chronic kidney disease has a serum potassium of 6.5 mEq/L.
Which action should the nurse anticipate first?
A. Administer sodium polystyrene sulfonate
B. Initiate dialysis
C. Administer IV calcium gluconate
D. Encourage high-potassium foods
Rationale: IV calcium gluconate stabilizes cardiac membranes immediately in hyperkalemia,
preventing life-threatening arrhythmias before other treatments.
7. A postoperative patient is at risk for deep vein thrombosis (DVT). Which
intervention is most appropriate?
A. Encourage bedrest
B. Apply warm compresses
C. Administer low-molecular-weight heparin (LMWH)
D. Provide high-protein diet
Rationale: LMWH is used prophylactically to prevent DVT in high-risk postoperative patients.
8. A patient reports sudden chest pain radiating to the left arm, shortness of
breath, and diaphoresis. The nurse suspects myocardial infarction. Which is the
first action?
A. Obtain a chest X-ray
B. Administer aspirin if not contraindicated
C. Start IV antibiotics
D. Prepare the patient for MRI
100-Question Practice Exam with Detailed
Answers and Rationales| pdf
Detailed Overview:
This study guide is a complete, exam-style practice resource for NSG 4100 Exam 3 (2026). It
contains 100 multiple-choice questions designed to cover the full spectrum of essential nursing
knowledge and clinical reasoning skills needed to succeed on the exam.
The questions encompass a variety of critical nursing areas, including:
1. Medical-Surgical Nursing: Assessment, management, and interventions for acute and
chronic conditions such as heart failure, COPD, pneumonia, pancreatitis, stroke, and
sepsis. Students will practice prioritizing care, identifying complications, and applying
evidence-based interventions.
2. Pharmacology: Knowledge of commonly prescribed medications, including mechanism
of action, side effects, interactions, and patient teaching. Focus areas include
anticoagulants, diuretics, insulin, corticosteroids, bronchodilators, and antibiotics.
3. Pathophysiology and Lab Interpretation: Understanding disease processes and
recognizing laboratory and clinical indicators of complications, such as DKA, hepatic
encephalopathy, electrolyte imbalances, and shock states.
4. Patient Safety and Nursing Interventions: Prioritization of nursing care, prevention of
hospital-acquired infections, pressure ulcers, and medication errors, along with proper
monitoring and rapid response to emergencies.
5. Critical Thinking and Clinical Judgment: Each question challenges the student to
analyze patient data, make safe clinical decisions, and implement appropriate
nursing interventions.
1. A patient with chronic heart failure is prescribed furosemide. Which
assessment finding indicates the medication is effective?
A. Increased heart rate
B. Decreased urinary output
C. Reduction in peripheral edema
D. Elevated blood pressure
Rationale: Furosemide is a loop diuretic that promotes fluid excretion. A reduction in edema
indicates effective fluid removal and symptom relief.
,2. A nurse is caring for a patient with COPD. Which oxygen delivery method
provides the most precise concentration?
A. Nasal cannula
B. Simple face mask
C. Venturi mask
D. Non-rebreather mask
Rationale: Venturi masks deliver a precise oxygen concentration, which is crucial for patients at
risk of CO2 retention, such as those with COPD.
3. A patient receiving vancomycin reports itching and develops a rash. What is
the nurse’s priority action?
A. Administer antihistamines and continue infusion
B. Stop the infusion and notify the provider
C. Slow the infusion rate
D. Monitor vital signs every 15 minutes
Rationale: Rash and itching may indicate “red man syndrome” or an allergic reaction. The
infusion should be stopped immediately and the provider notified.
4. A patient presents with a blood glucose level of 280 mg/dL and reports
polyuria, polydipsia, and blurred vision. Which condition is most likely?
A. Hypoglycemia
B. Type 1 diabetes mellitus
C. Hyperglycemia / uncontrolled diabetes
D. Syndrome of inappropriate antidiuretic hormone (SIADH)
Rationale: Symptoms of high blood sugar, including polyuria, polydipsia, and blurred vision,
indicate hyperglycemia, commonly seen in uncontrolled diabetes.
5. Which action should the nurse take first for a patient experiencing an
anaphylactic reaction?
, A. Administer corticosteroids
B. Administer epinephrine
C. Apply oxygen
D. Place the patient supine
Rationale: Epinephrine is the first-line treatment for anaphylaxis, as it reverses airway
constriction and hypotension. Oxygen and positioning follow.
6. A patient with chronic kidney disease has a serum potassium of 6.5 mEq/L.
Which action should the nurse anticipate first?
A. Administer sodium polystyrene sulfonate
B. Initiate dialysis
C. Administer IV calcium gluconate
D. Encourage high-potassium foods
Rationale: IV calcium gluconate stabilizes cardiac membranes immediately in hyperkalemia,
preventing life-threatening arrhythmias before other treatments.
7. A postoperative patient is at risk for deep vein thrombosis (DVT). Which
intervention is most appropriate?
A. Encourage bedrest
B. Apply warm compresses
C. Administer low-molecular-weight heparin (LMWH)
D. Provide high-protein diet
Rationale: LMWH is used prophylactically to prevent DVT in high-risk postoperative patients.
8. A patient reports sudden chest pain radiating to the left arm, shortness of
breath, and diaphoresis. The nurse suspects myocardial infarction. Which is the
first action?
A. Obtain a chest X-ray
B. Administer aspirin if not contraindicated
C. Start IV antibiotics
D. Prepare the patient for MRI
